Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.
Congenital Abnormalities ; Deglutition ; Humans ; Mastication ; Polymerization* ; Polymers* ; Prostheses and Implants ; Rehabilitation* ; Water

Dentinogenesis Imperfecta, with a high incidence rate of 1 : 6 - 8000, is inherited by autosomal dominant genetic transmission. This dental disorder causes discoloration of the teeth and the enamel and dentin show hypoplastic or hypocalcified defects which lead to frequent fractures and rapid attrition. Therefore, timely treatment is necessary for the preservation of the remaining teeth. In this particular case, a 19-year-old patient suffering from Type 1 dentinogenesis imperfecta showed signs of brownish hued teeth with multiple fractures, a loss of vertical dimension, excessive interdental space in the maxillary anterior teeth, and a lack of 5 posterior teeth. To improve the esthetic appearance of the anterior teeth, the vertical dimension was increased. Resin caps were used to alleviate the difficulty of taking an impression of multiple teeth at once. Monolithic zirconia materials used in this case showed high fracture strength and the ability to mask the discoloration of the teeth and therefore, functionally and esthetically favorable results were achieved.
Dental Enamel ; Dentin ; Dentinogenesis Imperfecta* ; Humans ; Incidence ; Masks ; Rehabilitation* ; Tooth ; Vertical Dimension ; Young Adult

PURPOSE: To compare clinical outcome of revision total knee arthroplasty (TKA) between the infected and non-infected groups. MATERIALS AND METHODS: This study compared the clinical and radiographic results of 21 infected and 15 non-infected revision TKAs at a minimum 2-years follow-up. Clinical evaluations were assessed using the range of motion (ROM), Hospital for Special Surgery (HSS) score, Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and Western Ontario and McMaster Universities (WOMAC) score. Radiologic evaluations were assessed using the radiographic results of the American Knee Society and joint line change. RESULTS: Patients operated for non-infectious causes had significantly better postoperative ROM than the infected group (infected group, 101.7degrees; non-infected group, 117.8degrees). The infected group achieved significantly poor HSS (79.2 vs. 85.5), KSKS (75.5 vs. 86.6), KSFS (76.9 vs. 85.5), WOMAC (30.3 vs. 21.2) scores than the non-infected group. Postoperative joint line elevation was lower in the infected versus non-infected group (0.5 mm vs. 2.1 mm), but there was no significant difference. CONCLUSIONS: Revision TKA is an effective treatment that can provide successful results in the infected as well as non-infected patients. The overall results of non-infected revision were more satisfactory than infected revision.
Arthroplasty ; Follow-Up Studies ; Humans ; Joints ; Knee ; Ontario ; Range of Motion, Articular

PURPOSE: Authors evaluated the effectiveness of pain relief of the femoral nerve block in multimodal pain control protocols for patients with total knee arthroplasty in early postoperative period. MATERIALS AND METHODS: Seventy-six patients who underwent TKA under general anesthesia were enrolled in this study. Preemptive analgesic medication, periarticular multimodal drug injection, and IV-PCA were used for pain control in all patients. This single-blind, randomized controlled trial included 43 patients in the nerve block group and 33 patients in the control group. In the former group, the femoral nerve block was done by one author with a nerve stimulator set using 0.5% bupivacaine 20 ml and 1% lidocaine 10 ml. Pain scale was measured at 6, 12, 24, 48, 72 hours and 7 days postoperatively. In addition, amount of IV-PCA consumption, numbers of using acute pain rescuer, range of motion, straight leg raising, first ambulation time, and complications related with drugs were evaluated. RESULTS: Pain scale and the amount of IV-PCA consumption were significantly lower in nerve block group until 48 hours (p=0.04, 0.03), and the range of motion was better compared to the control group (p< or =0.02). The number of pain rescue medicines was significantly low in nerve block group within the first 3 days postoperatively (1.36 vs 2.58). The ability to raise a straightened leg was recovered more rapidly in the control group than in the nerve block group; this difference was statistically significant (12 vs 27.9 hours, p=0.02). There were no differences in first ambulation time and incidence of complications between the 2 groups. CONCLUSION: Femoral nerve block in the early period after TKA under multimodal pain control protocols showed significant improvement in pain relief and in range of motion, as well as a significant decrease in the requirement of IV PCA and acute pain rescuers.
Acute Pain ; Anesthesia, General ; Arthroplasty ; Bupivacaine ; Femoral Nerve ; Humans ; Incidence ; Knee ; Leg ; Lidocaine ; Nerve Block ; Osteoarthritis ; Passive Cutaneous Anaphylaxis ; Range of Motion, Articular ; Walking

Extraskeletal osteosarcoma is a rare malignant tumor of soft tissue. In addition, there are only several cases of osteosarcoma of the mediastinum as a primary site in the world. We report a case of extraskeletal osteosarcoma arising in the posterior mediastinum. A 54-year-old man visited our hospital because of chest pain. Chest CT showed a 12 cm sized huge mediastinal mass. The mass revealed solid and ivory-colored cut surface with multifocally ovoid cystic spaces and hemorrhage. Microscopically, the tumor consisted of polygonal stromal cells, giant cells and varying amounts of neoplastic new bone, and mitotic figures were frequently observed. There were no distant metastasis and regional lymph node involvement.
Chest Pain ; Giant Cells ; Hemorrhage ; Humans ; Lymph Nodes ; Mediastinum* ; Middle Aged ; Neoplasm Metastasis ; Osteosarcoma* ; Stromal Cells ; Tomography, X-Ray Computed

Ultraviolet (UV) radiation is the main physiological stimulus for human skin pigmentation. Recently, nitric oxide (NO) have been involved in mediation of skin pigmentation induced by UVB. Rutin, a flavonoid of vegetables and fruits, has antiviral and antioxidant properties. Therefore, we investigated the effect of rutin on UVB-induced melano-genesis and NO production in HM3KO cells. In this study, we demonstrated that UVB-irradiation stimulated melanin content and tyrosinase activity in HM3KO cells. Rutin suppressed UVB-stimulated total melanin content and tyrosinase activity in a dose-dependent manner. Additionally, we showed that UVB-irradiation stimulated NO production in HM3KO cells. Rutin also suppressed UVB-induced NO production and repaired reduction of cell proliferation by UVB. UVB stimulation of melanogenesis was mimicked by exogenous NO donor (sodium nitroprusside, SNP), and rutin effectively suppressed it. Therefore, we concluded that rutin suppressed UVB-stimulated melanogenesis and that it is involved in melanogenesis regulation partially through the suppression of UVB-induced NO production.
Cell Proliferation ; Fruit ; Humans* ; Melanins ; Melanoma* ; Monophenol Monooxygenase ; Negotiating ; Nitric Oxide* ; Nitroprusside ; Rutin* ; Skin Pigmentation ; Tissue Donors ; Vegetables

PURPOSE: Since 1971, Nitrofen (2,4-dichloro-4`-nitrodiphenyl ether) herbicide has been known to induce variable congenital abnormalities in rats. However, until now there has been no animal model of congenital diaphragmatic hernia (CDH) using this herbicide in Korea. Therefore, CDH in rats using Nitrofen was tried for searching on pathogenesis or using therapeutic modalities of CDH. METHODS: 20 Sprague-Dawley rats ingested Nitrofen as indicated on the 9.5th day of gestation, and after sacrificing on the 21th day of gestation. 243 offspring were harvested for the examination of diaphragmatic herniations. Dissections were made along sites of herniations to confirm the diaphragmatic herniation's site and size, lung/body weight ratio comparison as well as to accomplish microscopic radial saccular counting and evaluation of alveolar septal wall maturations and a comparision was made between the groups. RESULTS: CDH appeared in 149 of 243 offspring. CDH only appeared in the posterior portion of the diaphragm regardless of size or the side of appearance. Left sided CDH was the most common single diaphragmatic anomaly, represented in 112 offspring. Right sided CDH was next, found in 31 offspring, and bilateral CDH was seen in 6 offspring. Left sided CDH was almost always associated with visceral herniations and with pulmonary hypoplasia on the affected side, which was proved in the decreased Lung/Body weight ratio and in decreased radial saccular counts and in increased alveolar septal wall thickness in the affected lungs of CDH. In94 offspring without CDH following exposure to Nitrofen, moderate pulmonary hypo plasia was microscopically observed. CONCLUSION: Initial Rat modeling of congenital diaphragmatic hernia using Nitrofen showed results of herniation and pulmonary hypoplasia of the affected lungs acceptable for further experimental studies on CDH and accompaning pulmonary abnormalities.
Animals ; Animals* ; Congenital Abnormalities ; Diaphragm ; Hernia, Diaphragmatic* ; Korea ; Lung ; Models, Animal* ; Pregnancy ; Rats* ; Rats, Sprague-Dawley

To select high risk group in middle cerebral artery(MCA) infarction by comparing and analysing 10 risk factors in above patients, we analyzed 32 MCA infarcted patients and 30 case control groups retrospectively. Through the analysis of 10 risk factors(age, heart disease, blood pressure, total cholesterol, triglyceride, HDL-cholesterol, glucose, smoking, r-GTP, past history : hypertension or cerebrovascular accident) in MCA infarction by the times patients arrieves in emergency room by scoring system made by author, MCA infarcted patients showed score about 1.4 in 24 cases(75.00%) among 32 MCA infarction patients, and in control group, score below 1.4 showed in 28 cases(93.33%) among 30 cases. By the scoring system made by author, the higher risk grouped patients could identified more easily in emergency department.
Blood Pressure ; Case-Control Studies ; Cholesterol ; Emergency Service, Hospital ; Glucose ; Heart Diseases ; Humans ; Hypertension ; Infarction* ; Infarction, Middle Cerebral Artery ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Triglycerides